Every cloud has a silver lining but… “pathways to seeking formal-help and South-Asian immigrant women survivors of intimate partner violence”

Abstract

It takes an inordinate amount of resiliency for South Asian (SA) immigrant women survivors of intimate partner violence (IPV)/domestic violence (DV) to seek outside help. The purpose of authors of this study is to understand the process/pathways used by abused SA women to seek formal sources of help. A convenience sample of adult SA women (N?=?9), who were survivors of IPV was recruited from a SA women's organization located in a large Southwestern metropolitan area in the United States. In-depth interviews were conducted and analyzed resulting in five themes. Despite seeking help, participants experienced barriers in accessing formal help and leaving an abusive relationship.     

Supporting female survivors of intimate partner violence with disabilities: Recommendations for social workers in the emergency department

Intimate partner violence (IPV) is a pervasive problem with grave consequences. Women with disabilities are among the most vulnerable groups disproportionately affected, with higher IPV rates than either women without disabilities or men with disabilities. The emergency department (ED) in particular affords a gateway into health services for female survivors of IPV, placing ED social workers in a prime position to observe potential signs of IPV and connect survivors to further assistance. This article explores the critical role ED social workers can fill in addressing the needs of female survivors of IPV with disabilities. We begin by providing background on the characteristics of IPV among women with disabilities, followed by a discussion of the opportunities and challenges inherent to assessing and intervening with survivors. We conclude by outlining recommendations for working with female survivors of IPV with disabilities in EDs, using our previous research on the topic as a guide.     

Help-seeking rates for intimate partner violence (IPV) among Canadian immigrant women

We examined rates of help seeking for intimate partner violence (IPV) among recent (0-9 years in Canada) and non-recent (10+ years in Canada) immigrant women. Data from a national, cross-sectional, telephone survey were used. Help-seeking variables included disclosure of IPV, reporting IPV to police, use of social services subsequent to IPV, and barriers to social service use. Recent immigrant women, compared with non-recent immigrant women, were significantly more likely to report IPV to police and less likely to use social services. Findings have important implications for prevention and detection of IPV in immigrant communities and in future research.     

Help-Seeking Rates for Intimate Partner Violence (IPV) Among Canadian Immigrant Women

We examined rates of help seeking for intimate partner violence (IPV) among recent (0–9 years in Canada) and nonrecent (10+ years in Canada) immigrant women. Data from a national, cross-sectional, telephone survey were used. Help-seeking variables included disclosure of IPV, reporting IPV to police, use of social services subsequent to IPV, and barriers to social service use. Recent immigrant women, compared with nonrecent immigrant women, were significantly more likely to report IPV to police and less likely to use social services. Findings have important implications for prevention and detection of IPV in immigrant communities and in future research.     

South Asian Immigrant Men and Women and Conceptions of Partner Violence

Limited knowledge exists about conceptual variations in defining intimate partner violence (IPV) by ethnicity, such as South Asian (SA) immigrant men and women. In a multi-ethnic study, we employed participatory concept mapping with three phases: brainstorming on what constitutes IPV; sorting of the brainstormed items; and interpretation of visual concept maps generated statistically. The parent study generated an overall general multi-ethnic map (GMEM) that included participant interpretations. In the current study, we generated a SA specific initial-map that was interpreted by eleven SA men and women in gender specific groups. Their interpretations are examined for similar and unique aspects across men and women and compared to GMEM. SA men and women shared similar views about sexual abuse and victim retaliation, which also aligned closely with GMEM. Both SA women and men had an expanded view of the concept of controlling behaviors compared to GMEM. SA women, unlike SA men, viewed some aggressive behaviors and acts as cultural with some GMEM congruence. SA women uniquely identified some IPV acts as private–public. We discuss implications for research and service assessments.     

Process of forgiveness in the recovery of Chinese women survivors of intimate partner violence: Empowerment,transformation, and integration

Forgiveness has been found one substantial element in the recovery for women survivors from intimate partner violence following the termination of the abusive relationship. To further investigate the details of forgiveness in this specific context, the present study explored the process of forgiveness using grounded theory. In-depth and semi-structured interviews were conducted with 25 Chinese women survivors of IPV. The findings suggest that forgiveness is a strength-based process including empowerment, transformation, and integration phases. In the empowerment phase, survivors obtain strength at the intrapersonal, behavioural, and interpersonal levels. In the transformation phase, survivors complete cognitive transformation for their IPV experiences and emotional transformation towards former partners. In the integration phase, survivors—now freed from the past—reflect upon and apply the changes they have undergone. Two trajectories in the process were found. One trajectory is going through stages sequentially and the other trajectory is experiencing back and forth between empowerment and transformation stages before moving into the integration stage. The study's findings broaden our knowledge of the strength-based forgiveness process that women survivors of IPV undergo during recovery. Practitioners and policymakers could develop programmes and policies that support forgiveness by holistically facilitating their recovery and empowerment like assistance in dealing with life difficulties and promoting their reconnection with social networks. To improve the transferability and validity of the findings, the forgiveness of survivors of IPV could be explored in a diverse sample (e.g., survivors with low educational background or live in the rural area).     

Social context and drivers of intimate partner violence in rural Kenya: implications for the health of pregnant women

More than half of rural Kenyan women experience intimate partner violence (IPV) in their lifetime. Beyond physical consequences, IPV indirectly worsens maternal health because pregnant women avoid antenatal care or HIV testing when they fear violent reprisal from partners. To develop an intervention to mitigate violence towards pregnant women, we conducted qualitative research in rural Kenya. Through eight focus group discussions, four with pregnant women and four with male partners, and in-depth interviews with service providers, we explored the social context of IPV using an ecological model. We found that women experienced physical and sexual IPV, but also economic violence such as forced exile from the marital home or losing material support. Relationship triggers of IPV included perceived sexual infidelity or transgressing gender norms. Women described hiding antenatal HIV testing from partners, as testing was perceived as a sign of infidelity. Extended families were sometimes supportive, but often encouraged silence to protect the family image. The broader community viewed IPV as an intractable, common issue, which seemed to normalise its use. These results resonate with global IPV research showing that factors beyond the individual – gender roles in intimate partnerships, family dynamics and community norms – shape high rates of violence.     

Out of Africa: Coping Strategies of African Immigrant Women Survivors of Intimate Partner Violence

We explored the coping behaviors of 15 immigrant African survivors of intimate partner violence (IPV) in the United States. Similarities and differences in coping strategies between African and other immigrant women were noted. Results from the qualitative analysis are that African immigrant survivors utilized multiple coping strategies including beliefs in spirituality and divine retribution, a future orientation, and a sense of self-efficacy. Acceptance/ endurance of abuse, which they believe was “normal” in male/ female relationships; minimization of the abuse; and avoidant behaviors and thoughts also were used. Informal and formal support/help seeking, and knowledge of available services empowered women. Implications for policy, practice, and future research are discussed.     

Discursos profesionales sobre la violencia del compañero íntimo: implicación en la atención de las mujeres inmigrantes en España

Objective1) to examine the discourses of professionals involved in the care of female victims of intimate partner violence (IPV), with emphasis on how they describe the immigrant women, the perpetrators and their own responsibility of care; and 2) to compare these discourses with the other professions involved in caring for these women (social services, associations and police and justice).MethodsQualitative study based on semi-structured interviews with 43 professionals from social services, associations and the police and judicial systems. A discourse analysis was carried out to identify interpretive repertoires about IPV, immigrant women and their aggressors, their culture and professional practices.ResultsFour interpretive repertoires emerged from professional discourses: “Cultural prototypes of women affected by IPV”, “Perpetrators are similar regardless of their culture of origin”, “Are victims credible and the perpetrators responsible?” and “Lack of cultural sensitivity of professionals in helping immigrant women in abusive situations”. These repertoires correspond to preconceptions that professionals construct about affected women and their perpetrators, the credibility and responsibility they attribute to them and the interpretation of their professional roles.ConclusionsThe employment of IPV-trained cultural mediators in the services responsible for caring for the female victims, together with cultural training for the professionals, will facilitate the provision of culturally sensitive care to immigrant female victims of intimate partner violence.     

The association between length of stay in Canada and intimate partner violence among immigrant women

OBJECTIVE: We examined the prevalence of intimate partner violence (IPV) among recent (0-9 years) and nonrecent (>/= 10 years) immigrant women in Canada to determine whether differences in IPV were associated with length of stay in Canada. METHODS: We analyzed data from the 1999 General Social Survey, a national cross-sectional telephone survey. We used weighted logistic regression analysis to examine the effect of length of stay in Canada on IPV and controlled for socio-cultural and other factors associated with IPV. RESULTS: The crude prevalence of IPV was similar among recent and nonrecent immigrant women. However, after adjustment, the risk for IPV was significantly lower among recent immigrant women compared with nonrecent immigrant women. Country of origin, age, marital status, and having an activity limitation (physical/mental disability or health problem) also were associated with a higher risk for IPV. CONCLUSIONS: Our findings have important implications for both prevention and detection of IPV among immigrant women.     

Attitudes of women toward intimate partner violence: a study of rural women in Nigeria

Predictors of rural women's attitudes in Nigeria toward intimate partner violence (IPV) were investigated using a random sample of rural women (n = 3911) aged 15-49 years from the 2003 Nigeria Demographic and Health Survey (NDHS). Findings were suggestive of social, religious, and cultural influences in the women's attitudes towards IPV. Women resident in the three northern regions, the South South region, Muslim women, women with low levels of education and low household wealth were more likely to tolerate IPV. This is reflective of the socio-economic disadvantages they face, as well as the cultural and religious restrictions imposed on these women.     

How do women in Spain deal with an abusive relationship?

OBJECTIVES: To determine the different responses adopted by women in Spain who are victims of intimate partner violence (IPV); identify the different sociodemographic profiles associated with each response; analyse the factors contributing to adopting a response; and study the association between the different types of response and the different types of IPV. DESIGN: Cross sectional study. SETTING: 23 volunteer general practices in Spain. PARTICIPANTS: 1402 randomly selected women. MAIN OUTCOME MEASURE: Women's response to IPV: none, partner separation, reporting the case to the police, seeking help from healthcare professionals and seeking help from associations for battered women. RESULTS: Lifetime prevalence of any type of IPV (physical, psychological, and/or sexual) was 32%. Sixty three per cent of abused women took some kind of action to overcome IPV. Women who separated from their partners were mostly younger, with a smaller number of children and higher income and educational levels, compared with those abused women who reported the abuse to the police or sought help from healthcare professionals or associations for battered women. Independent factors associated with presenting a response to IPV were: being separated/divorced/widowed, having social support, having experienced IPV frequently, and having experienced physical and psychological abuse (compared with psychological abuse alone). Women who experienced the three types of abuse were also more likely to respond to violence. CONCLUSIONS: Identifying the factors that have an influence on the response adopted by abused women allows us to better understand the support needed by them to abandon an abusive relationship.     

Depression and Social Support Among Women Living with the Substance Abuse,Violence, and HIV/AIDS Syndemic: A Qualitative Exploration

BackgroundIntimate partner violence (IPV), HIV/AIDS, and substance use are described as the SAVA “syndemic” among low-income urban women because of their intersecting and synergistic presence in these women's lives. Depressive symptoms are significantly associated with these SAVA factors and although social support is potentially protective for depression, little is understood about its impact on depression associated with the SAVA syndemic.MethodsThis paper investigates how women living with SAVA experience and describe depressive symptoms, and examines how the types of social support they access impact their experiences of SAVA and depressive symptoms. Qualitative, in-depth interviews were conducted with 24 HIV-positive, low-income, urban women who experienced IPV and used cocaine or heroin in their lifetime. Interviews were analyzed based on study aims, principles of thematic content analysis, and grounded theory.ResultsWomen identified multiple SAVA factors as catalysts for depression and noted their synergistic effect on depressive symptoms, which were both a trigger for and a result of drug use. Women accessed varying sources of social support to address their SAVA factors and associated symptoms of depression, relying on informal sources for instrumental support related to IPV and formal sources for support related to HIV, drug use, and depression.ConclusionsThese findings have important implications for health providers who serve SAVA-affected women, and suggest that comprehensively addressing all SAVA factors (and IPV in particular) and improving their access to quality social support at critical times is essential to improve their mental health.     

Intimate Partner Violence and Help-Seeking Among Ethiopian Women

Although intimate partner violence (IPV) is a widespread phenomenon in Ethiopia, the relationship between help-seeking sources and IPV is not well understood. Better understanding of this relationship could play a role in preventing IPV. We used data collected in the 2016 Ethiopia Demographic and Health Survey and limited our study to women who have ever been married, aged 15 to 49 years (n?=?4469). Overall, the proportions of women who have ever experienced emotional abuse, physical, or sexual violence were 24%, 23.1%, and 10.1%. Women who sought informal help (family) were 2.42 times more likely (OR?=?2.42; CI 1.29–4.55) to have ever experienced emotional abuse than women who did not seek family help. Neither formal nor informal help-seeking significantly associated with physical or sexual violence. The results may indicate difficulties women face in seeking help and cultural and social norms that tolerate IPV as an acceptable part of family life in Ethiopia.

     

Missed opportunities: intimate partner violence in family practice settings

BACKGROUND: For women experiencing partner violence, women health care visits represent opportunities for physicians and patients to address intimate partner violence (IPV), a significant health threat for women. OBJECTIVES: The objectives were to estimate rates of physician documentation of IPV in medical records; characterize IPV+ women most likely to have IPV documented; and determine whether IPV screening increased IPV documentation. METHODS: Subjects were women ages 18-65 receiving primary care in two large family practice clinics. All were screened for IPV by study staff using a modified Index of Spouse Abuse and the Women's Experience with Battering scales. We selected and abstracted medical records for all women experiencing current IPV (N = 144) and a random sample of women never experiencing IPV (N = 147). RESULTS: Of 144 women screened as currently experiencing IPV, 14.7% were documented. Women most likely to have IPV documented were Caucasian, with higher WEB scores, and more likely to have an event that could trigger posttraumatic stress syndrome. Although the majority (41/56) of women currently in physically violent relationships did not plan to disclose IPV, those disclosing were significantly more likely to have IPV documented and documentation occurred after screening for 60% of women experiencing IPV. CONCLUSION: IPV screening increased documentation. IPV screening can provide the opportunity for patients to disclose IPV. Physicians then have the opportunity to compassionately connect patients with appropriate resources.     

Association between intimate partner violence and HIV status among Haitian Women

ABSTRACT

The prevalence of intimate partner violence (IPV) among women living in Haiti increased from 25% in 2006–29% in 2012, with escalating reports of crisis in the last several years. We examined the association between IPV and HIV status among these women in Haiti. Participants were drawn from a larger sample of women (n?=?513) with a history of IPV. Women living with HIV (n?=?55) were matched to uninfected women (n?=?110) to form a control group. Attitudes towards gender roles, mental and physical well-being, and partner violence were assessed and compared. Logistic regressions were utilised to calculate multivariable-adjusted odds ratios. Women living with HIV were more likely to report more severe forms of psychological violence (p?<?0.01), and severe physical violence (p?<?0.0001). Women who experienced severe forms of IPV were 3.5 times more likely to have an HIV positive status compared to those who did not experience severe IPV (p?<?0.0001). There were significant associations between severe forms of IPV, and HIV status among Haitian women. IPV severity should be integrated into eligibility screening for biomedical strategies of prevention such as pre-exposure prophylaxis (PrEP) among Haitian women.     

Modelling the effects of intimate partner violence and access to resources on women's health in the early years after leaving an abusive partner

Although the negative health effects of intimate partner violence (IPV) are well documented, little is known about the mechanisms or determinants of health outcomes for women who had left their abusive partners. Using data collected from a community sample of 309 Canadian women who left an abusive partner, we examined whether women's personal, social and economic resources mediate the relationships between the severity of past IPV and current health using structural equation modelling. A good fit was found between the model and data for hypothesized models of mental and physical health. In the mental health model, both the direct and total indirect effects of IPV were significant. In the physical health model, the direct effect of IPV on physical health was about four times as large as the total indirect effects. In both models, more severe past IPV was associated with lower health and women's personal, social, and economic resources, when combined, mediated the relationship between IPV and health. These findings demonstrate that the health outcomes of IPV for women who have left an abusive partner must be understood in context of women's resources.     

Opportunities and obstacles to screening pregnant women for intimate partner violence during antenatal care in Zimbabwe

Pregnancy offers an opportunity for midwives to recognise and respond to women experiencing intimate partner violence (IPV). However, most antenatal care interventions have been conducted in private specialist services in high-income countries and do not address the structural and cultural realities of developing country settings. We report on an exploratory qualitative study conducted in antenatal public health facilities in Harare, Zimbabwe, involving six in-depth interviews with midwives and seven FGDs with 64 pregnant and postpartum women. Recorded interviews were transcribed verbatim and analysed using thematic content analysis. We found that identifying and responding to IPV in antenatal care is hampered by inadequate human, financial and infrastructural resources as well as poor support of gender-based violence training for midwives. Midwives had divergent views of their role, with some perceiving IPV as a non-clinical, social and domestic problem that does not require their attention, while others who had been sensitised to the problem felt that it could easily overwhelm them. A comprehensive response to IPV by midwives would be difficult to achieve in this setting but sensitised midwives could respond to cues to violence and ultimately assist abused women in culturally sensitive and appropriate ways.     

Intimate Partner Violence,Depression, PTSD,and Use of Mental Health Resources Among Ethnically Diverse Black Women

This study examined exposure to violence and risk for lethality in intimate partner relationships as factors related to co-occurring MH problems and use of mental health (MH) resources among women of African descent. Black women with intimate partner violence (IPV) experiences (n?=?431) were recruited from primary care, prenatal or family planning clinics in the United States and the U.S. Virgin Islands. Severity of IPV was significantly associated with co-occurring MH problems, but was not associated with the use of MH resources among African-American women. Risk for lethality and co-occurring problems were also not significantly related to the use of resources. African Caribbean women with severe physical abuse experiences were significantly less likely to use resources. In contrast, severity of physical abuse was positively associated with the use of resources among Black women with mixed ethnicity. Severe IPV experiences are risk factors for co-occurring MH problems, which in turn, increases the need for MH services. However, Black women may not seek help for MH problems. Thus, social work practitioners in health care settings must thoroughly assess women for their IPV experiences and develop tailored treatment plans that address their abuse histories and MH needs.